Zarnescu N O, Costea R, Zarnescu Vasiliu E C, Neagu S
Second Department of Surgery, University Emergency Hospital Bucharest, Romania ; "Carol Davila" University of Medicine and Pharmacy Bucharest, Romania.
Second Department of Surgery, University Emergency Hospital Bucharest, Romania.
J Med Life. 2015 Oct-Dec;8(4):523-6.
Background/ Aims: Despite the existence of an easy tool to diagnose biliary tract disease as an etiology for acute pancreatitis (AP), the sensitivity of abdominal ultrasound is around 80%, which can be even lower in certain conditions.
We have retrospectively reviewed data of 146 patients admitted for acute pancreatitis between 1999 and 2013. Bivariate analysis for clinical and biochemical variables was performed with respect to etiology of AP (biliary versus non-biliary). Multivariate analysis was performed by using binary logistic regression.
There were 87 males (59.6%) and 59 females (40.4%), with a median age of 51. The etiology of acute pancreatitis was biliary in 71 patients (48.6%). Bivariate analysis found the following as significant association (p=0.001) with biliary pancreatitis: older age, female gender, and elevated AST, ALT. A binary logistic regression analysis identified as predictor factors for biliary etiology of acute pancreatitis: age OR = 1.031 (95% CI 1.004 - 1.059, p = 0.024), sex (female) OR = 2.34 (95% CI 1.022 - 5.359, p = 0.044) and ALT OR = 1.004 (95% CI 1.001 - 1.007, p =0.004). The two clinical scores included the three variables (A.S.ALT scores) in categorical format were generated and then checked with the ROC curves (areas under curve are 0.768 and 0.778).
Age, female gender, and elevated ALT can help identifying cases with biliary etiology of acute pancreatitis.
背景/目的：尽管存在一种简便工具可将胆道疾病诊断为急性胰腺炎（AP）的病因，但腹部超声的敏感性约为80%，在某些情况下甚至可能更低。
我们回顾性分析了1999年至2013年间因急性胰腺炎入院的146例患者的数据。对急性胰腺炎的病因（胆源性与非胆源性）进行了临床和生化变量的双变量分析。采用二元逻辑回归进行多变量分析。
男性87例（59.6%），女性59例（40.4%），中位年龄51岁。71例（48.6%）急性胰腺炎的病因是胆源性。双变量分析发现以下因素与胆源性胰腺炎有显著相关性（p = 0.001）：年龄较大、女性性别以及AST、ALT升高。二元逻辑回归分析确定急性胰腺炎胆源性病因的预测因素为：年龄OR = 1.031（95%CI 1.004 - 1.059，p = 0.024），性别（女性）OR = 2.34（95%CI 1.022 - 5.359，p = 0.044）和ALT OR = 1.004（95%CI 1.001 - 1.007，p = 0.004）。生成了包含三个变量（A.S.ALT评分）分类形式的两个临床评分，然后用ROC曲线进行检验（曲线下面积分别为0.768和0.778）。
年龄、女性性别以及ALT升高有助于识别急性胰腺炎胆源性病因的病例。
